Merck is expected to have a leg-up in the Chronic Refractory Cough market over other key players owing to an early entry of its drug, Gefapixant (MK-7264), among all the CRC pipeline therapies.
LAS VEGAS, July 19, 2021 /PRNewswire/ -- DelveInsight'sChronic Refractory Cough (CRC) Marketreport offers comprehensive coverage of the current treatment practices, pipeline drugs, Chronic Refractory Cough market share of the individual therapies, current and forecasted CRC market size from 2018 to 2030 segmented into 7MM (the USA, EU5 (the UK, Italy, Spain, France, and Germany), and Japan).
The total Chronic Refractory Cough prevalent population in the 7 major markets was estimated to be 17,600,264 in 2020, which is further estimated to rise at a CAGR of 0.48% during the forecast period 2021–2030.
The expected rise in the CRC prevalence can be attributed to increased research, development, public awareness, and improved diagnosis, mainly due to the advent of new biomarkers.
The USAaccounted for the highest prevalence of Chronic Refractory Cough, followed by France in the 7 MM in 2020, with females accounting for a larger CRC prevalent population.
The higher CRC prevalence in women can be ascribed to a heightened capsaicin cough reflex sensitivity in women than in men.
The present Chronic Refractory Cough treatment market comprises the use of various off-label therapies and over-the-counter drugs like Neuro-modulating agents (Opioids, Baclofen, Gabapentin, Pregablin, and Amitriptyline), Proton Pump inhibitors, Inhaled corticosteroids (ICs), and others along with non-pharmacological treatments like speech therapy.
The Chronic Refractory Cough market size in the 7MM was estimated to be USD 6,118.6 Million in 2020.
Key players such as Merck, Bayer, Bellus Health, Shionogi, Nerre Therapeutics, and others are actively developing treatments for CRC.
The launch of pipeline therapies in late and mid-stage developments, including Orvepitant Maleate, BLU-5937, Gefapixant, BAY1817080, and S-600918, is expected to expand the growth quadrant of the Chronic Refractory Cough market size in the coming years.
Gefapixant (Merck) is currently in the Phase III stage of development, followed by Orvepitant Maleate (Nerre Therapeutics).
Merck's Gefapixant is expected to face backlash as the drug, despite showing promising efficacy data, is associated with serious adverse events. However, a severe dearth of approved therapies in the Chronic Refractory Cough therapy market may streamline its success trajectory.
Orvepitant Maleate has demonstrated no safety concerns in the treated population with excellent tolerability. If approved, the drug has the potential to capture a major CRC market share.
Out of all the emerging therapies, four therapies target the P2X3 inhibition, the only clinically validated treatment approach so far investigated.
The Chronic Refractory Cough market dynamics are anticipated to change further during the forecast period 2021-30 owing to the launch of these therapies, increasing prevalence, better healthcare spending, improved diagnostics, and better awareness.
Cough is a reflex activity in response to elements that irritate the throat and airways leading to voluntary control. If it lasts for less than 3 weeks, the cough is acute, while Chronic cough lasts for more than 8 weeks.
Chronic cough often occurs after a viral infection. It can also occur as an underlying symptom of respiratory diseases such as gastroesophageal reflux disease (GERD), postnasal drip from sinus or allergies, or chronic lung conditions, such as asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and interstitial lung diseases.
The most common signs and symptoms of Chronic Refractory Cough include a persistent cough/ dry irritating cough localized around the laryngeal region coupled with wheezing, stridor, dyspnea, hoarseness or aphonia, and tenderness over the laryngotracheal cartilage.
Chronic refractory cough is a condition associated with a considerable burden on the patients. The total diagnosed Chronic Refractory Cough prevalent cases in the 7 MM was estimated to be 10,560,159 in 2020, with the United States accounting for the maximum cases. Further, a higher CRC prevalence was observed in females than males.
The Chronic Refractory Cough market report puts forward the epidemiological analysis for the study period 2018-30 in the 7MM segmented into:
Chronic Cough Prevalent Population
Gender-specific Chronic Cough Prevalent Population
Chronic Refractory Cough Prevalent Population
Diagnosed Chronic Refractory Cough Prevalent Population
Diagnosed CRC Prevalent Population in Idiopathic Pulmonary Fibrosis (IPF) patients
The CRC market is dominated by non-pharmacologic therapies, which include Speech Therapy and Physiotherapy followed by off-label and over-the-counter medications. These include neuromodulators (like opioids, baclofen, gabapentin, pregabalin, and amitriptyline), proton pump inhibitors, inhaled corticosteroids (ICs), and others. One commonly used drug is codeine, which is a weak opioid, however, it is not an ideal antitussive. Tramadol, another opioid medication with a similar structure to codeine and morphine, has shown efficacy with its antitussive properties. Gabapentin and pregabalin (centrally acting neuromodulators) have shown potential in improving cough.
The present Chronic Refractory Cough treatment market comprises no approved therapy. Currently, the market of CRC is supported by various treatment options, such as inhaled corticosteroids, neuromodulators, proton pump inhibitors, and opioids, which include gabapentin, pregabalin, morphine, amitriptyline, baclofen, etc. that consumed as off-labels.
Also, it is worth noting that these interventions are approved for chronic cough but, to date, there is no such intervention available, which can treat a recurrence of cough, i.e., chronic refractory cough. Further, there is a lack of availability of specific biomarkers that can help in the accurate and timely diagnosis of Chronic Refractory Cough. Biochemical analysis is required to exactly get an insight into how actually a disease is prevailing, i.e., pathways or mechanisms involved with it.
Diagnosis remains for the majority of cases indicative in nature rather than diagnostic due to the lack of definite markers. Thus, it can be concluded that for systematic diagnosis, there is a major need for efficient biomarkers so as to have a targeted treatment approach.
Chronic Refractory Cough Market
The United States accounts for the largest Chronic Refractory Cough market size throughout the study period of 2018–2030, in comparison to the EU5 (the United Kingdom, Germany, Italy, France, and Spain) and Japan.
The Chronic Refractory Cough market is anticipated to experience an influx of several pharma and biotech companies such as Merck, Bayer, Bellus Health, Shionogi, Nerre Therapeutics and others who are actively involved in strengthening the Chronic Refractory Cough pipeline. According to DelveInsight's CRC market analysis, among all the potential emerging therapies, Gefapixant (MK-7264), which is being developed by Merck, is estimated to enter the CRC market at the earliest, as the drug has already been completed several phase II and III developmental trials successfully. The drug has demonstrated quite impressive efficacy and consistent safety and tolerability profile. Besides, a major drawback that comes with this therapy is the incidence of serious adverse events and a high incidence of taste-related adverse events, which led to few treatment discontinuations. However, due to high unmet needs, lack of approved therapies, and recent acceptance of NDA by the FDA, the probability of the success of Gefapixant to enter the market is expected to be relatively high.
DelveInsight estimates that a significant rise in the CRC prevalence is going to give momentum to the Chronic Refractory Cough market share growth in the next decade. Many patients with chronic cough require multiple clinical encounters to obtain a diagnosis, with over half remaining undiagnosed. However, the last decade witnessed significant scientific achievement in understanding the mechanisms of chronic cough, which has led to multiple clinical drug development programs exploring potential novel agents. Furthermore, an increase in healthcare spending & R&D and better awareness around the condition are expected to propel the market growth.
The lack of an effective cure in the market has managed to pull in several pharma and biotech companies to investigate novel agents and develop effective cures for CRC. However, the launch of pipeline therapies is set to be encumbered by the CRC market dominance of off-label and OTC drugs, which are relatively available without any prescriptions and at much cheaper costs. Thus, the fate of therapies will be reliable on patient acceptance as well. Moreover, a significantly high trial failure rate exacerbates the quandary. The CRC market has witnessed the terminations of trials investigating TRP modulators and NK1 antagonists in the late stages, leaving the CRC market in an unpleasant situation.
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